If you are applying by the OPM Form 1203-FX, leave this section blank.

7. Background Information

If you are applying by the OPM Form 1203-FX, leave this section blank.

8. Other Information

If you are applying by the OPM Form 1203-FX, leave this section blank.

9. Languages

If you are applying by the OPM Form 1203-FX, leave this section blank.

10. Lowest Grade

01

11. Miscellaneous Information

If you are applying by the OPM Form 1203-FX, leave this section blank.

12. Special Knowledge

If you are applying by the OPM Form 1203-FX, leave this section blank.

13. Test Location

If you are applying by the OPM Form 1203-FX, leave this section blank.

14. Veteran Preference Claim

15. Dates of Active Duty - Military Service

16. Availability Date

17. Service Computation Date

18. Other Date Information

If you are applying by the OPM Form 1203-FX, leave this section blank.

19. Job Preference

If you are applying by the OPM Form 1203-FX, leave this section blank.

20. Occupational Specialties

001 Clinical Psychologist

21. Geographic Availability

487210309 Waco, TX

22. Transition Assistance Plan

23. Job Related Experience

If you are applying by the OPM Form 1203-FX, leave this section blank.

24. Personal Background Information

If you are applying by the OPM Form 1203-FX, leave this section blank.

25. Occupational/Assessment Questions:

The assessment part of the questionnaire includes questions about your eligibility and basic requirements. Please choose A (Yes) or B (No) in response to the following questions.

1. Are you a US Citizen?

A. YesB. No

2. Do you have a degree Have a doctoral degree in psychology from a graduate program in psychology accredited by the American Psychological Association (APA). The specialty area of the degree must be consistent with the assignment for which the applicant is to be employed.

A. YesB. No

3. Have you successfully completed a professional psychology internship training program that has been accredited by APA.

A. YesB. No

4. Have you completed any new VHA psychology internship programs that are in the process of applying for APA accreditation?

A. YesB. No

5. Were you at a VHA facilities who offered full one-year pre-doctoral internships prior to PL 96-151 (pre-1979)?

A. YesB. No

6. Hold a full, current, and unrestricted license to practice psychology at the doctoral level in a State, Territory, Commonwealth of the United States (e.g., Puerto Rico), or the District of Columbia.

A. YesB. No

7. Are you proficient in spoken and written English are required by 38 U.S.C. 7402(d) and 7407(d)?

A. YesB. No

Certification of Understanding - Select the appropriate answer to the statement below. Failure to provide an answer will result in your not being considered for this position.

8. I certify that, to the best of my knowledge and belief, all of the information included in this questionnaire is true, correct, and provided in good faith. I understand that if I make an intentional false statement, or commit deception or fraud in this application and its supporting materials, or in any document or interview associated with the examination process, I may be fined or imprisoned (18 U.S.C. 1001); my eligibilities may be cancelled; I may be denied an appointment; or I may be removed and debarred from Federal service (5 C.F.R. part 731). I understand that any information I give may be investigated and that responding "No" or providing no response to this item will result in my not being considered for this position.

A. YES, I understand the information provided above and certify that the information provided in this questionnaire is true, correct, and provided in good faith.B. NO, I do not certify this information and do not wish to be considered for this position.